How much rates vary
Facilitymedian $166 · 10th to 90th $98 to $2,570Professionalmedian $135 · 10th to 90th $25 to $240
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $208.93 | Professional | None | $79.43 | $128.82 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $204.17 | Professional | None | $109.65 | $109.65 | $204.17 |
BCBS Texas Setting Facility Modifier None Typical Low $85.11 Median $147.91 Typical High $1,047.13 | Facility | None | $85.11 | $147.91 | $1,047.13 |
BCBS Texas Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $245.47 | Professional | None | $97.72 | $158.49 | $245.47 |
Baylor Scott & White Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $257.04 | Professional | None | $158.49 | $169.82 | $257.04 |
Christus Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $131.83 Typical High $190.55 | Facility | None | $66.07 | $131.83 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $218.78 | Professional | None | $100.00 | $154.88 | $218.78 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,202.26 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $977.24 Typical High $4,570.88 | Facility | None | $102.33 | $977.24 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $223.87 | Professional | None | $79.43 | $128.82 | $223.87 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $117.49 Typical High $173.78 | Professional | None | $21.88 | $117.49 | $173.78 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $138.04 Typical High $213.80 | Facility | None | $66.07 | $138.04 | $213.80 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $218.78 | Professional | None | $100.00 | $154.88 | $218.78 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $204.17 | Professional | None | $87.10 | $134.90 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $39.81 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $25.12 Typical High $31.62 | Professional | 53 · Discontinued | $15.85 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $93.33 Typical High $117.49 | Professional | 54 · Surgery only | $58.88 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $18.62 Typical High $23.44 | Professional | 55 · Aftercare only | $11.75 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.88 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.94 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $87.10 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $54.95 | $87.10 | $109.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $39.81 | $63.10 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $25.12 Typical High $31.62 | Professional | 53 · Discontinued | $15.85 | $25.12 | $31.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $93.33 Typical High $117.49 | Professional | 54 · Surgery only | $58.88 | $93.33 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $18.62 Typical High $23.44 | Professional | 55 · Aftercare only | $11.75 | $18.62 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.88 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.94 | $12.88 | $15.85 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $87.10 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $54.95 | $87.10 | $109.65 |
Where Texas sits
The same service costs 3.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 47th of 51
$138
AK $427KY $123
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.